On April 1, 2013, the State of California was awarded a State Innovation Model (SIM) Design Grant from the federal Center for Medicare and Medicaid Innovation (CMMI). The grant is supporting California to develop a State Health Care Innovation Plan (Innovation Plan), which will form the basis of a forthcoming application for a three-year State Innovation Model Testing grant. The Innovation Plan must address all three aspects of the Triple Aim – better health, better health care, and lower costs, demonstrate a return on investment within the three-year time frame, include a broad array of stakeholders and multiple payers, affect a preponderance of care, and leverage existing initiatives and investments.
California intends to utilize existing state and national initiatives including capitated payment models, accountable care organizations, bundled episode payments, the Coordinated Care Initiative for dual-eligible Medi-Cal and Medicare beneficiaries, and the state’s Section 1115 Medi-Cal Bridge to Health Care Reform Waiver to inform their model design. California’s design process will involve a broad range of advocacy groups that will address its diverse and geographically spread population in order to develop a model that reflects California’s complex health care and financing environment.
